Leading From the Trenches: The Role of the Radiation Therapist “Super User” in the Implementation of a New Treatment Planning System

Radiation Therapist (RT) clinical practice is in a state of constant technological change. Even when that change seems simple, the implementation of new technology can cause complex and intertwined clinical practice and cultural changes, which result in poor communication, stress and resistance to change. Recently, a large urban cancer program moved to a new treatment planning system that enables dose reconstruction and adaptive replanning. To facilitate that change, 4 RTs were identified to lead the transition. This abstract will describe the impact of these RTs in the implementation of that new treatment planning system. Four frontline Therapists were identified as “Super Users” (RTSUs) for the new treatment planning system, based on the breadth and depth of their clinical expertise and their innate leadership abilities. In preparation for the clinical implementation, this team; actively participated in the multidisciplinary project leadership meetings, designed and implemented multidisciplinary education sessions, contributed to the building of robust systems of nomenclature, identified and created diverse sets of test-cases for training and physics measurement, and led the development of clinical workflows and protocols that closely reflected RT practice. During the transition, they were a vital conduit for nimble communication about the transition; from the frontline staff directly to the leadership, and vice versa, leading the seamless transition across a large, multidisciplinary department. After the implementation of 8 inverse planning techniques, the RTSUs continue to support, educate and troubleshoot for the entire multidisciplinary team. They remain deeply engaged in the multidisciplinary implementation leadership meetings, where they articulate and advocate for the concerns and needs of frontline RTs. The role of the RTSU in leading this technological change yielded many benefits. They brought RT practice insights into the change management discussions, resulting in a much smoother clinical implementation than had been experienced during similar changes. This high degree of implementation practicality brought high levels of buy-in from the frontline RTs, bringing about feelings of joint ownership. Importantly, the quality of their contribution during the transition planning leadership meetings has brought a deep respect for the opinions and abilities of the Radiation Therapy profession. Challenges for the RTSUs were learning to advocate for the needs of our profession in a multidisciplinary environment, and being prepared to justify and defend their decisions. Managing resistance to change from all levels and all professions was a difficult process. And finally, all these new responsibilities were done in addition to the usual treatment planner workload. The RTSUs have played an invaluable role in leading change during the implementation of that new treatment planning system in a department of more than 290 staff and trainees. Radiation therapy clinical practice has transitioned to the new system with no interruption in the timeliness of patient care. The contribution that the RTSUs made has resulted in an enduring impact on the involvement of frontline RTs in change leadership at our cancer centre.